Nokea
In the most common type of CAR:
- A. There is deficient 11-hydroxylase
- B. Hypertension is a feature
- C. There is an associated gene defect
- D. Transmission is autosomal dominant
Correct Answer: B
Rationale: Hypertension is a feature of congenital adrenal hyperplasia (CAH) caused by deficiencies in enzymes involved in steroidogenesis, including 11-hydroxylase.
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The parents of a 3-month-old ask why their baby will not have an operation to correct a ventricular septal defect (VSD). The nurse's best response is:
- A. It is always helpful to get a second opinion about any serious condition like this.
- B. Your baby's defect is small and will likely close on its own by 1 year of age.
- C. It is common for physicians to wait until an infant develops respiratory distress before they do the surgery.
- D. With a small defect like this, they wait until the child is 10 years old to do the surgery.
Correct Answer: B
Rationale: Most small VSDs close spontaneously within the first year of life.
Regarding insulin administration in diabetics:
- A. Short-acting insulin reaches peak action in 4-6 hours after injection
- B. In a twice daily regimen involving Mixtard 30 or Humulin M3, the bedtime reading is an effect of the long-acting component
- C. A bedtime blood sugar level of 10 mmol/l is unacceptable
- D. Using the same site for injections is a common cause of increasing insulin dosage
Correct Answer: B
Rationale: The bedtime reading in a twice-daily regimen involving Mixtard 30 or Humulin M3 is influenced by the long-acting component, which has a prolonged effect.
A 6-year-old child has a systolic blood pressure between the 95th and 99th percentile for age, sex, and height and a diastolic blood pressure between the 90th and the 95th percentile on three separate clinic visits. This child's blood pressure is placed in which classification?
- A. normotensive
- B. pre-hypertensive
- C. stage 1 hypertensive
- D. stage 2 hypertensive
Correct Answer: C
Rationale: Stage 1 hypertensive pressure ranges from the 95th percentile or from 120/80 mm Hg to 5 mm Hg above the 99th percentile for age, sex, and height for either systolic or diastolic pressure.
Diseases that primarily involve the motor unit include:
- A. Werdnig-Hoffman disease
- B. Guillain-Barre syndrome
- C. Facioscapulohumeral dystrophy
- D. Charcot-Marie-Tooth disease
Correct Answer: A
Rationale: Werdnig-Hoffman disease, also known as spinal muscular atrophy type 1, primarily affects the motor neurons in the spinal cord.
Three days after a female client with multiple sclerosis (MS) is admitted to the hospital with a severe urinary tract infection, she reports experiencing double vision. Which intervention should the nurse implement?
- A. Patch one eye and then the other every few hours
- B. Encourage bedrest until the diplopia is resolved
- C. Instruct the client to limit intake of oral fluids
- D. Administer artificial tear drops to both eyes
Correct Answer: A
Rationale: Patching each eye helps alleviate double vision caused by MS-related vision impairment.